"It’s tempting to interpret the waning economic prospects and cultural relevance of rural America as an inevitable consequence of casual bigotry. If these people were just a bit more forward-looking—more accepting of immigrants and gay people, more interested in new technology—then maybe people like me would stay put. And maybe those states would still be attracting employers. Maybe there would be TV shows and movies set there. Maybe they’d even be drawing in transplants rather than hemorrhaging the best and brightest of each generation. Oppressive state laws can drive people away; in several states, for example, major businesses have scuttled investment plans in response to anti-LGBT legislation. The Associated Press found that North Carolina’s so-called bathroom bill, passed last year, will end up costing the state at least $3.76 billion over twelve years in canceled business.

Yet in the end, this vision of culture-wide economic payback for the politically backward interior is as much a fantasy as the notion that Trump can bring back manufacturing jobs. The real reason that jobs have disappeared from large swathes of the country has more to do with neoliberalism than with social issues. Broadly speaking, California is a winner in this system. Most other places in America are not.

The Golden State has long contained some of the richest zip codes in the country, but it’s increasingly becoming a state where only the wealthy can build a decent life for themselves. This is apparent in places like Los Angeles’ Boyle Heights, where my friend flies his rebel flag but rising housing prices are breaking up the Latino community that’s called the neighborhood home since the 1950s. Zoom out the lens, and you can see that it’s not just a local issue: since 2011, housing prices across the state have gone up 71 percent. That’s had real consequences. Between 2007 and 2014, more people left California than migrated here. Leading the exodus were people without college degrees—in other words, the same demographic that’s credited with delivering Trump a landslide victory in red states.

The hard truth about liberal secession fantasies is that California is not a place where progressive policies enable everyone to become successful. It’s a place to which people move to enjoy their success when they’ve beaten the odds elsewhere. As Kendrick Lamar reminded us, people come to California for “women, weed, and weather”—not decent wages, affordable education, and accessible health care.

Ruiz Evans’s case for secession rests on the claim that Californians’ “views on education, science, immigration, taxation and healthcare are different” from those prevailing in much of the rest of the country. This is certainly true when you look at polling on the issues. But when it comes to policies and outcomes, California’s unique values are less apparent. To take just the first example on Ruiz Evans’s list, California’s per-pupil spending on K-12 education has declined for years, falling well below the national average. In this realm, California is comparable to states like Florida and Texas—even though California also boasts some of the highest-performing high schools in the nation. This is not a sign of our more progressive views on education; it’s an indication that the state is deeply segregated along lines of race and class."

…

"The heartland isn’t monolithically conservative. My home state of Iowa split its Senate seats for decades, electing both a liberal member and a conservative one, and many of the midwestern states that delivered Trump the Electoral College have a similar history of mixed representation. Now that Trump is going to fail to deliver on his promises to improve the economic prospects of the people who voted for him in these states, the time is ripe for liberals to put forth an economic agenda that rests not on racial fearmongering but on guaranteed access to health care, fair wages, education, and affordable housing.

And as it turns out, these needs are every bit as acute in California as they are in Iowa. To move toward a true majoritarian liberal strategy means we must challenge more than a few ingrained narratives about American politics. It means rejecting the fallacy that California is a liberal utopia, a place where we coastal transplants can enjoy the moral high ground over our high school classmates who remained in our hometowns to raise their families. It also means dispensing with the opposite fallacy: that those who stayed behind have some sort of shopworn dignity that the rest of us lack.

And this is because, ultimately, division helps Trump advance his agenda. It keeps Republicans firmly in control of state legislatures and the House. So we must resist the urge to smugly turn our backs on the glum spectacle of the self-inflicted economic immolation of Trump country. We must keep it together. If you had a choice about where to build your life, you now have an obligation—not to move back to your beleaguered homeland, but to stay engaged with it. And if you hope to maintain any genuine sort of moral high ground in your adopted state, you have an obligation there, too: to work to make its policies align with your beliefs.

This is not, as Rich suggests, as simple as adopting Trump’s shoot-from-the-hip rhetorical style. Nor is it a question of luring venture capitalists to rural Ohio—where, in all likelihood, they would bring the same mounting inequality and diminished returns that have made Silicon Valley a fortress of paper wealth. It’s a matter of supporting candidates who share our values and have a track record of actually getting them enacted in policy. That’s a hard thing to prove when Democrats are not in power. But as I write these words, opinion polls show that Bernie Sanders is the most popular political leader in the country. Surely that suggests an opportunity to build on the best parts of his 2016 platform and to get behind other Democrats who are known for supporting such policies. There are several, like Sherrod Brown and Elizabeth Warren, who enjoy a cross-demographic appeal. The time is also ripe to capitalize on the fiasco of Trumpcare and place single-payer health reform back on the table. Similar opportunities will surely present themselves on other issues, from education reform to infrastructure investment, as the president fails to deliver on promises to his base. The trick will be to continue to frame these issues as nationwide problems that we all have a stake in solving.

Those of us who have the economic freedom to migrate to pursue better jobs and a broad range of economic opportunities are the ones who bear the greatest burden for bridging the country’s internal geopolitical divides. Believe me, I understand the temptation to separate yourself: it’s true that I am different from the people I grew up with who chose to stay in Iowa. Part of that difference is, now, an economic and cultural advantage. So I have a dual responsibility: to see that California actually makes good on its professed values, and to ensure that those values incorporate the rest of America. Refusing to rationalize elite neglect is the real rebellion."

"Political reality, then, makes it absolutely clear that Democrats need to deliver meaningful improvements to people's daily lives if they are going to keep their supermajority. However, that doesn't mean they should just pass whatever they want. Legislators should assume any tax increase or substantial policy action will be put on the ballot for a referendum by wealthy conservatives. Democratic leaders will need to work hand-in-hand with California's progressive movement to determine and then implement a reform agenda over the next two years. Only by a coordinated effort will that reform agenda withstand the certain counterrevolution from the rich that would come at the November 2014 ballot.

What should that agenda look like? Here are just a few ideas:

Make it even easier to vote…
Bring even more revenue to the schools…
Make sure every Californian gets good health care…
Do something to create jobs…
Fix the Constitution…"

"…inequities in the system…shortage of physicians…can be long waits for elective procedures & non-urgent doctor visits. For most Canadians cost of drugs, dental care & some psychiatric services is not included in basic package…benefits vary somewhat by province.<br />
<br />
But Canada’s medical outcomes are excellent; urgent needs get urgent care; Canadians live 2yrs longer…Problems like medical bankruptcy are virtually unknown…overwhelming majority of Canadians…prefer their system over ours…<br />
<br />
We learned that doctors in Canada earn a good income not much different from most of those in the US. Although most have a good quality of life with adequate free time, some are overworked & a few can’t find positions due to lack of facilities in some specialties. But few Canadian physicians emigrate, &…each year since 2004 more physicians have returned to Canada than have moved abroad.<br />
<br />
Canadians were totally perplexed as to why Americans have put up with our faulty & expensive system for so long."

"Statement of Principles: We support a universal health care system for the State of Vermont, one that includes all Vermonters, offers free choice of providers, is progressively financed, decoupled from employment, affordable for all, and pays for all necessary care out of public funds; a system which retains the private delivery of health care and has a publicly accountable budget process to ensure adequate capacity to meet the health care needs of all Vermonters. "